- Objective To investigate factors associated with latent syphilis and pregnancy outcome among women with latent syphilis. Methods A retrospective population-based study was conducted to compare all pregnancies among women with and without latent syphilis at Soroka University Medical Center, Be'er-Sheva, Israel, between 1988 and 2010. Stratified analysis using a multiple logistic regression model was performed to control for confounders. Results Of the 219 656 deliveries during the study period, 159 (0.1%) involved women with latent syphilis. Multivariate analysis with backward elimination revealed the following conditions to be significantly associated with latent syphilis: fetal growth restriction (odds ratio [OR] 2.20; 95% confidence interval [CI], 1.07–4.49; P = 0.03); drug abuse (OR 9.95; 95% CI, 1.31–75.46; P = 0.02); tobacco use (OR 3.35; 95% CI, 1.74–6.45; P < 0.05); and Jewish (vs Bedouin) ethnicity (OR 4.05; 95% CI, 2.65–6.20; P < 0.05). Conclusion Women with latent syphilis are at risk for adverse maternal and perinatal outcomes, including fetal growth restriction. Careful surveillance of these high-risk pregnancies should be considered.